JAIH-S International Health Training Camp 2008.

I was given an opportunity to participate in a four-day global health training program that was carried out by the Students' Division of the Japan Association for International Health (JAIH-S) from March 13th to the 16th. The main aim of this annual program is for the participants to be able to (1) create an image of what working in the global health field is like, and (2) know what you can do and how to start it.

We had lectures done by people currently working at the front lines in this field, including staff from the International Health Center Japan, a tropical medicine researcher, an epidemiologist, officers from the Ministry of Health, Labor, and Welfare (MHLW), and health specialists from NGOs, JICA (Japan International Cooperation Agency), and UNICEF. The lectures were followed by many group activities including discussions, debates, and a PCM (project cycle management) workshop which we had to work on through a night to complete.

My impression? Well... frankly speaking, I felt a little weird throughout the program. Of course, all the participants were highly-motivated, deep-thinking, yet thoughtful people who had gathered from around the country, and without question, the chats with them were really stimulating and one of those memorable times. However, most, if not all of them, were drawn by the terms 'global health' or 'international health', while on the other hand, my interest doesn't necessarily have to go beyond the border, as my 'theme' is community-based health care or primary health care (PHC). Yes, often times, these words have been talked about more in the developing communities rather than the industrialized ones so no doubt it does have a 'global health' taste to it, however, when you take a close look at the developed communities, you actually do see many forms of community health, and plus, there are many things these communities around the globe can learn from each other.

And, another reason for my feeling not right is probably due to the fact that many of the speakers have already literally abandoned the clinical part of being a physician. In other words, many of the doctors in this field do not see patients anymore at a hospital or clinic. Yes, it is true that so-called logistic-type jobs are more needed than specialized people like doctors or nurses. For example, when you take infectious diseases, the main underlying issues in the developing communities are more basic, such as sanitation or health education, and tackling these issues is the most radical solution. Treating patients and prescribing drugs is also a job that can not be cut, but it does little in terms of remedying the bigger picture. So what's needed in the field of international cooperation? Leadership, management, communication skills, and creative thinking. It's what one of the lecturers said, and I agree.

However, at this point, I have no thought of abandoning the clinician's work. Well, that's what I am studying medicine for right now! To obtain specialized skills. Yes, I am interested in public health, community health, and doing positive things for the bigger public, but I want to do that through interacting with the patients. So the image of my future I have right now could be called 'clinical epidemiology-based community health'. In other words, through interacting with the people, know the community, know its strengths, weaknesses, and hidden potentials, and do something creative to bring out their strengths to make the community happier as a whole, with the people in the community. This training program helped me reaffirm my interest.

By the way, I had a chance to talk with Dr. Honda, the founder and current chair of SHARE, the biggest non-profit organization in Japan specializing in international health cooperation, and I was deeply moved by his talks, as he and I had so many common interests... his 'theme' also sounded like community-based health care and primary health care (PHC). :-)

Goodbye to a flying sports car.

Fleet rationalization is happening everywhere in the commercial aviation industry. With fuel prices sky-rocketing, airlines are doing whatever they can to cut costs, and fleet simplification is one of them.

That is no exception with the airlines of Japan too. When Japan Airlines (more commonly referred to by its ICAO three-letter code JAL) and Japan Air System (JAS) merged in 2002 to take on All Nippon Airways (ANA), which had and still has the biggest share of the domestic market in terms of passenger numbers, it not only created an initial series of coordination problems but also a diverse fleet as well, as the two only had one aircraft type in common. Operating more aircraft means more maintenance work, a larger spare parts inventory, more training of its employees, etc, which adds to costs.

For example, the competitors in the short-haul market are the Airbus A320 family, Boeing's 737 family, and the McDonnell Douglas (merged into Boeing in 1997) MD-80/90 series. Production of the latter was terminated not long after its takeover by its former arch-rival, so essentially the A320 and 737 have the market all to themselves now.

JAL had been operating a substantial fleet of 737s, while JAS had been loyal to the Long Beach-based manufacturer, operating the MD-80 and also acquiring the advanced MD-90s in the mid-1990s. So the merged airline operating two (or three) major types for the short-haul sector was naturally deemed uneconomical, and the decision was made to acquire newer 737s to eventually replace the Douglas twin-jets. JAS operated the MD-81, MD-87, and MD-90, and the first to say farewell became the MD-87.

First delivered to JAS on June 3, 1988, the fleet eventually built up to eight aircraft. The MD-87 is basically a MD-82 (a MD-81 with more powerful engines) with a shortened fuselage, compromising capacity for longer range and better take-off and landing performance. JAS acquired these 117-seat jets, sometimes nicknamed the "flying sports car" for its superior climbing performance, to bring jet age to the local regional airports in Japan with limited runway length. These markets had long been served by the Japanese-built NAMC YS-11 turboprop airliner.

After the merger, all eight were repainted in JAL's new "Arc of the Sun" corporate livery which was developed by Landor Associates, however, as the merged airline took delivery of more newer 737s, it was only a matter of time before retirement. So the first of eight was withdrawn from service in October 2007, and the ultimate aircraft is now planned to operate its last revenue flight on March 31, 2008, flight JL1386 from Nanki-Shirahama to Tokyo's Haneda airport. All were already withdrawn from scheduled service by the end of February, and have since been operating mainly as back-up equipment.

The MD-87 was never the most popular jetliner like Boeing's venerable 747, but it did have its own niche, and brought jet age to the regional airports in Japan, boosting tourism. It surely will be missed by its crews, employees, and those local airplane spotters. Fortunately, many are now finding a new lease of life in Thailand with low-fare airline One-Two-Go (a subsidiary of Orient Thai Airlines), instead of being reduced to piles of metal somewhere in the southwestern USA where many older jetliners end their life.

Farewell, sports car in the sky. :-)